Progressive systemic sclerosis commonly involves the esophagus. Both conventional recumbent barium esophagrams with fluoroscopy and esophageal manometry have been used to determine such involvement. In an attempt to ascertain which of these two modalities is more sensitive in detecting esophageal disease, 27 patients with biopsy-proven progressive systemic sclerosis were studied. Manometry provided the more accurate index of esophageal involvement. Indeed, as demonstrated in this study, normal barium studies do not exclude extensive esophageal disease.
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